All dental practices should properly and regularly maintain dental unit water lines as part of their regular infection control protocols. While infections caused by contaminated water lines are rare, especially among healthy individuals, other people, such as the elderly and patients with compromised immune systems, may be more susceptible to infection.
Dental unit water lines can harbor numerous microorganisms that can multiply inside the tubing and result in biofilms that can harbor bacteria, fungi, algae and protozoa. Once formed, biofilms can increase the numbers of free-floating microorganisms in water that exits the water lines. Proper and regular maintenance of dental unit water lines will help ensure that the water that runs through the lines meets the safe drinking water standard.
颁顿颁鈥檚 advises that:
鈥淎ll dental units should use systems that treat water to meet drinking water standards (i.e., 鈮 500 CFU/ mL of heterotrophic water bacteria). Independent reservoirs鈥攐r water-bottle systems鈥攁lone are not sufficient. Commercial products and devices are available that can improve the quality of water used in dental treatment. Consult with the dental unit manufacturer for appropriate water maintenance methods and recommendations for monitoring dental water quality.鈥
Based on the agency鈥檚 guidance, combination approaches are an effective way to adequately control dental unit water quality. It鈥檚 important to recognize that an independent water reservoir/bottle alone is not enough. The biofilm in the dental unit water line must be controlled by additional technologies registered by the Environmental Protection Agency (EPA) or cleared by the Food and Drug Administration (FDA) for dental unit water quality management. Examples include:
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chemical treatment regimens
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source water treatment systems
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point-of-use filters
When performing surgical procedures, use only sterile solutions as a coolant/irrigant using an appropriate delivery device, such as a sterile bulb syringe, sterile tubing that bypasses dental unit waterlines, or sterile single-use devices. Guidance on dental unit water quality can be found in the 颁顿颁鈥檚 and the 颁顿颁鈥檚 questions and answers on . While the suggestions above are options, all practices should strictly adhere to appropriate maintenance protocols and check with the manufacturer of their dental units before implementing any procedures or processes to ensure compliance with the agency鈥檚 recommendations. If you are using a waterline disinfectant or system, verify your processes with the manufacturer.
Refer to 糖心logoDo鈥檚 and Don鈥檛s for Maintaining Dental Unit Water Lines for more information and helpful tips. Links to additional information available through the 糖心logo (ADA) are included in the list of Resources below.
Resources:
- 颁顿颁鈥檚 [PDF]
- 颁顿颁鈥檚 [PDF]
- 颁顿颁鈥檚
- CDC's
- 糖心logoDo鈥檚 and Don鈥檛s for Maintaining Dental Unit Water Lines [PDF]
- ADA
- 糖心logoInformation on Oral Health Topics, Dental Unit Waterlines